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Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV).Other types of viral hepatitis include:
  • Hepatitis A
  • Hepatitis C
  • Hepatitis D
Causes, Incidence, And Risk Factors for Hepatitis B
Hepatitis B infection can be spread through having contact with the blood, semen, vaginal fluids, and other body fluids of someone who already has a hepatitis B infection.Infection can be spread through:
  • Blood transfusions (not common in the United States)
  • Direct contact with blood in health care settings
  • Sexual contact with an infected person
  • Tattoo or acupuncture with unclean needles or instruments
  • Shared needles during drug use
  • Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person.
The hepatitis B virus can be passed to an infant during childbirth if the mother is infected.
Risk factors for hepatitis B infection include:
  • Being born, or having parents who were born in regions with high infection rates (including Asia, Africa, and the Caribbean)
  • Being infected with HIV
  • Being on hemodialysis
  • Having multiple sex partners
  • Men having sex with men
Most of the damage from the hepatitis B virus occurs because of the way the body responds to the infection. When the body’s immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.
Complications for Hepatitis Bhere is a much higher rate of hepatocellular carcinoma in people who have chronic hepatitis B than in the general population.
Other complications may include:
  • Chronic persistent hepatitis
  • Cirrhosis
  • Fulminant hepatitis, which can lead to liver failure and possibly death
Nursing Assessment NCP Nursing Care Plan for Hepatitis B
Patient history. Question the patient about potential sources of transmission and risks: a history of blood dyscrasias, multiple blood or blood product transfusions, alcohol or drug abuse (sharing of needles), exposure to hepatotoxic chemicals or medications, and travel to third world countries or areas where the sanitation is poor. Since HAV transmission occurs in association with daycare centers, among male homosexuals, and among household contacts of persons with acute cases, inquire into these areas. Also ask about recent meals, because hepatitis A occasionally occurs from contaminated food or improper sewage treatment. Determine the patient’s occupation; teratogen exposure may cause a nonviral hepatitis.
Diagnostic tests for Viral hepatitis
  • Antibody to HBsAg (Anti-HBs) — a positive result means you have either had hepatitis B in the past, or have received a hepatitis B vaccine
  • Antibody to hepatitis B core antigen (Anti-HBc) — a positive result means you had a recent infection or an infection in the past
  • Hepatitis B surface antigen (HBsAg) — a positive result means you have an active infection
  • Hepatitis E surface antigen (HBeAg) — a positive result means you have a hepatitis B infection and are more likely to spread the infection to others through sexual contact or sharing needles
• Activity intolerance
• Anxiety
• Deficient knowledge (diagnosis and treatment)
• Fear
• Imbalanced nutrition: Less than body requirements
• Risk for infection
• Risk for injury
Nursing Key outcomes NCP Nursing Care Plan for Hepatitis B
  • The patient will perform activities of daily living within the confines of the disease process, Extent of active management of energy to initiate and sustain activity.
  • The patient will identify strategies to reduce anxiety, Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source.
  • The patient and family will express an understanding of the disease process and treatment regimen Ability to acquire, organize, and use information. Verbalize understanding of condition/disease process and treatment.
  • The patient will discuss fears and concerns, Acknowledge and discuss fears, recognizing healthy versus unhealthy fears.
  • The patient will achieve adequate caloric and nutritional intake, Display normalization of laboratory values and be free of signs of malnutrition.
  • The patient will remain free from signs and symptoms of infection, patient will Identify interventions to prevent/reduce risk of infection.
  • The patient will avoid complications, Demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.
Nursing interventions NCP Nursing Care Plan for Hepatitis B
  • Activity Therapy: Prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual’s (or group’s) activity. Energy Management: Regulating energy use to treat or prevent fatigue and optimize function. Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health
  • Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress
  • Teaching Individual about disease, diagnosis and treatment. Learning Facilitation: Promoting the ability to process and comprehend information. Learning Readiness Enhancement: Improving the ability and willingness to receive information.
  • Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
  • Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
  • Infection Protection: Prevention and early detection of infection in a patient at risk. Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making
  • Surveillance: Safety: Purposeful and ongoing collection and analysis of information about the patient and the environment for use in promoting and maintaining patient safety. Analysis of potential risk factors, determination of health risks, and prioritization of risk reduction strategies for an individual or group. Environmental Management Manipulation of the patient’s surroundings for therapeutic benefit

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